Upper GI Pathologies

Question 1

two types of oesophageal cancer

Answer 1

squamous and adeno

Question 2

which type of oesophageal cancer are smoking, alcohol and dietary carcinogens risk factors for

Answer 2

squamous carcinoma

Question 3

what is Barrett’s oesophagus

Answer 3

a metaplasia whereby the squamous epithelium of th eosophagus is replaced by glandular epithelium as a result of oesophageal reflux

Question 4

more common hiatus hernia cause of oesophageal reflux

Answer 4

sliding hiatus hernia

Question 5

5 pathologies of upper GI tract

Answer 5

oesophageal reflux
oesophageal cancer
gastritis
peptic ulcetration
gastric cancer

Question 6

what is a hiatus hernia

Answer 6

where part of the stomach moves up into the thorax (i.e. past diaphragm)

Question 7

two types of hiatus herbia

Answer 7

sliding and para-eosophageal

Question 8

most common type of hiatus hernia

Answer 8

sliding

Question 9

which parts of the stomach herniate in sliding

Answer 9

cardiac region and fundus

Question 10

which parts of the stomach herniate in para-oesophageal

Answer 10

the fundus

Question 11

why is reflux more common in sliding than in para-oesophageal

Answer 11

because the mechanism of sliding means that the LOS is as contracted and the stomach contents can freely escape upwards

Question 12

two main complications of hiatus hernia related reflux

Answer 12

fibrotic healing forming strictures

barrett’s oesophagus

Question 13

what is the relatinoship between barrett’s and oesophageal cancer

Answer 13

barrett’s is a precursor to cancer

Question 14

which type of oesophageal cancer, squamous or adenocarcinoma, is most likely to occur from barrett’s oesophagus

Answer 14

adenocarcinoma (barrett’s is metaplasia of glandular epithelium

Question 15

what is the 3rd most common alimentary cancer

Answer 15

oesophageal cancer

Question 16

red flag symptoms of oesophageal cancer

Answer 16

dysphagia, vomiting, weight loss and symptoms of GI blood loss like haematemesis or dizziness

Question 17

where does oesophageal cancer most commonly metastasise to

Answer 17

liver

Question 18

5 non red flag symptoms of oesophageal cancer

Answer 18

painful swallowing, hoarseness, retrosternal pain, uncontrollable hiccups and lympadenopathy

Question 19

oesophageal cancer has a good/poor prognosis

Answer 19

poor - 5 year is <15%

Question 20

what is gastritis

Answer 20

inflammation of stomach lining

Question 21

what can gastritis lead to

Answer 21

stomach ulcer

Question 22

what vitamin deficiency arises from autoimmune gastritis

Answer 22

b12, pernicious anaemia

Question 23

the 3 types of gastritis

Answer 23

autoimmune, bacterial and chemical injury

Question 24

pathophysiology of gastritis

Answer 24

disruption of mucus later/acid production –> stomach lining exposed to acid –> damage

Question 25

common drug that causes gastritis

Answer 25

NSAIDs

Question 26

where could bile reflux from to cause chemical gastritis

Answer 26

the duodenum

Question 27

3 causes of chemical gastritis

Answer 27

drugs, alcohol and bile reflux

Question 28

in autoimmune gastritis what are the antibodies targeted against

Answer 28

parietal cells and intrinsic factor

Question 29

most common type of gastritis

Answer 29

bacterial

Question 30

most common cause of bacterial gastritis

Answer 30

H. Pylori

Question 31

H. Pylori is gram negative/positive

Answer 31

negative

Question 32

pathophysiology of a gastric ulcer

Answer 32

commonly H. Pylori caused gastritis --> ulcer forms

Question 33

2 main causes of gastric ulcers

Answer 33

H. Pylori and NSAIDs (aspirin ibruprofen)

Question 34

Presentation of a gastric ulcer

Answer 34

``` epigastric pain nausea and vomiting weight loss (less nutrition) haematemesis (if bleeding ulcer) anaemia ```

Question 35

peritoneal complication of a gastric ulcer

Answer 35

peritonitis when the the ulcer perforates

Question 36

chronic complication of ulcer bleeding

Answer 36

anaemia

Question 37

2nd most common alimentary cancer

Answer 37

gastric

Question 38

histological types of gastric cancer

Answer 38

adenocarcinoma

Question 39

what infection is gastric cancer associated with

Answer 39

H. Pylori

Question 40

ways in which gastric cancer may spread

Answer 40

directly to surrounding structures, lymphatically, through blood and transcoelomically (in peritoneal cavity)

Question 41

stomach is retro/intra peritoneal

Answer 41

intraperitoneal

Question 42

presentation of gastric cancer

Answer 42

``` dyspepsia dysphagia early satiety weight loss nausea and vomiting anaemia ```

Question 43

how does gastric cancer present in 70% of cases

Answer 43

with dyspepsia and no more

Question 44

why should you refer all cases of dyspepsia for an endoscopy

Answer 44

because 70% of gastric cancer presents with just dyspepsia

Question 45

gastric cancer has a good/poor prognosis

Answer 45

poor - 5 year <20%

Question 46

type of epithelium in stomach

Answer 46

simple columnar

Question 47

type of epithelium in oesophagus

Answer 47

stratified squamous